Mapping Out One’s Own Paths Toward Work: Focus on Experiences of Return to Work After Spinal Cord Injury

Abstract

Involving persons with spinal cord injury (SCI) as experts in their lives is important for research to design relevant health care interventions. The purpose of this study was to use photovoice methods to explore experiences of barriers and possibilities in return to work among working adults with SCI. The photovoice group consisted of six persons living with SCI that met weekly over 2 months to share and discuss photos related to return to work. Five themes were identified: (a) there is only one way, (b) welcome back-or not, (c) to be like anyone else-or to be perceived as someone else, (d) friction in the absence of clarity, and (e) finding integrated strategies for everyday life with work. Work was experienced as rewarding and viable, but due to lack of societal and workplace support, a need to map out one's own paths toward work was identified.

Challenging conceptualisations of work: Revisiting contemporary experiences of return to work and unemployment

“…Conceptualisations of return-to-work and unemployment have received less attention in occupational science and occupational therapy literature than the topic of work. Literature concerning return-to-work has primarily focused on a poor fit between employee abilities and the demands of work (Jakobsen, 2004(Jakobsen, , 2009, difficulties adapting to a (new) worker role (Soeker, 2011), expectations and conditions for return to work (Bergmark et al, 2011;Holmlund, Guidetti et al, 2018;Holmlund, Hultling, & Asaba, 2018), struggles adapting to (new) routines and travel to maintain employment (Crooks et al, 2009;Soeker, 2011), and intervention studies (Öst-Nilsson et al, 2017(Öst-Nilsson et al, , 2019. Studies concerned with unemployment have largely focused on its negative consequences for people's sense of identity, well-being, and belonging (Crooks et al, 2009;Jakobsen, 2004;Stone, 2003) and the ways in which it presents a significant disruption to opportunities for achieving health through occupation (Wright Vos et al, 2019).…”

“…Very little attention has been paid to the definition of unemployment, though it appears that most occupation-focused scholarship equates unemployment to the lack of paid employment (O'Halloran et al, 2018). Both return-to-work and unemployment have primarily been elucidated from an individualistic standpoint, but scholars are increasingly attending to the social expectations and structural conditions that hinder or prohibit people's access to work Berr et al, 2019;Burchett & Matheson, 2010;Holmlund, Hultling, & Asaba, 2018;Jakobsen, 2009;, 2017Lintner & Elsen, 2018), in line with the broader uptake of critical perspectives in occupationfocused scholarship (Farias & Laliberte Rudman, 2016).…”

Evaluating the feasibility of ReWork-SCI: a person-centred intervention for return-to-work after spinal cord injury

“…The development and modelling was conducted in three steps: (1) identification of guiding principles and components for ReWork-SCI; (2) modelling of preliminary intervention steps (within the research group); and (3) modelling of the intervention in a collaborative workshop with stakeholders (physician, occupational therapist, social worker, officers from the SSIA and the SPES and persons with SCI). The guiding principles for ReWork-SCI were: (1) acknowledgement of the person's experiences; life situation, and context; 3-5 10 33 35 (2) early but time-sensitive actions; 3 5 10 14 24 25 (3) integration and rootedness in the multi-professional team; 10 14 20 (4) systematic structure and coordination of multidisciplinary actions; 3 4 10 14 15 (5) support in finding and integrating strategies for everyday life with work; [3][4][5] and (6) support in finding strategies for dialogue at the workplace. 3 4 10 The components and the intervention steps for ReWork-SCI are outlined in figure 1.…”

“…RTW is particularly impacted by physical disability and medical complications following injury, which consequently can lead to a need for adjustments in everyday life. [1][2][3][4][5] This can imply limited opportunities in the labour market 3 and low employment rates. [6][7][8] Despite an emphasis on the right to work for people with disability, 9 there is a risk that people with SCI remain outside the labour market, stay unemployed or are granted sick leave/disability pension without access to relevant and fair support in the RTW process.…”

Participatory research: A promising approach to promote meaningful engagement

“…When we take a closer look at CBPR as an approach to research [10,18], diverse frameworks appear in the literature. Examples include: Participatory Action Research (e.g., [19][20], CBPR (e.g., [8]), participatory community methods (e.g., [21][22]), and participatory visual methods [9,[23][24][25][26][27][28]. Each of these illustrations call for working together with the community.…”